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MDS 2021 | The impact of LCIG on dyskinesia duration & severity in PD

The COmedication Study assessing Mono- and cOmbination Therapy with levodopa-carbidopa inteStinal Gel (COSMOS) (NCT03362879) investigated the use of levodopa-carbidopa intestinal gel (LCIG) in advanced Parkinson’s Disease (PD). Alfonso Fasano, MD, PhD, University of Toronto, Toronto, Canada, details the findings of an investigation into the impact of LCIG on dyskinesia duration and severity in participants of the COSMOS study. Overall, dyskinesia severity and duration improved after LCIG treatment. However, the follow-up period was relatively short, and Dr Fasano highlights the importance of considering the effectiveness of the treatment over a prolonged period. Studies have shown the long-term administration of levodopa to result in troublesome dyskinesia symptoms in approximately 40% of patients with advanced PD. Continual receptor stimulation with a specific dose of levodopa may worsen dyskinesia symptoms as the body’s sensitivity to levodopa increases over time. The dose at which levodopa is administered can also impact the type of dyskinesias that are observed in patients—at a low constant dose, atypical dyskinesias can occur, while increasing the dose can result in peak dose dyskinesias. This interview took place during the 2021 International Congress of Parkinson’s Disease and Movement Disorders.

Disclosures

Dr Fasano reports the following disclosures:
Receipt of grants/research support: Boston Scientific, MJ Fox Foundation, Medtronic, University of Toronto, McLaughlin Centre
Receipt of honoraria or consultation fees: Abbott, Abbvie, American Academy of Neurology, Brainlab, Boston Scientific, Ceregate, Chiesi Farmaceutici, Inbrain, International Parkinson and Movement Disorder Society, Ipsen, Medtronic, Novartis, TEVA Canada, UCB pharma, Sunovion
Participation in a company sponsored advisory board: Abbott, Abbvie, Boston Scientific, Ipsen, Medtronic, Sunovion